New Delhi, March 21 : Researchers from premiere institutes like NIMHANS and AIIMS have adapted a standardised test for dementia screening that can now be used in Hindi, Telugu, Kannada, Malayalam, Urdu and Tamil -- apart from English.
A team of researchers, including from the National Institute of Mental Health and Neurosciences (NIMHANS) and the All India Institute of Medical Sciences (AIIMS), have adapted the tests in these seven languages that will also check for mild cognitive impairment.
They have adapted the Addenbrooke's Cognitive Examination (ACE-III), a well-known screening instrument for dementia detection/diagnosis.
ACE-III had previously been adapted and validated into Gujarati.
The work was carried out by the University of East Anglia (UEA) in the UK and in India at NIMHANS and Manipal Hospitals, Bengaluru; Nizam's Institute of Medical Sciences, Hyderabad; Shree Chitra Tirunal Institute for Medical Sciences and Technology (SCTIMST), Trivandrum; AIIMS, Delhi; and Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry.
"With the rising burden of dementia globally, there is a need to harmonise dementia research across diverse populations," said Suvarna Alladi, professor of neurology at NIMHANS in Bengaluru and the lead researcher.
The ACE-III is a well-established cognitive screening tool to diagnose dementia, but there have been few efforts to standardise the use of it across cohorts speaking different languages.
"We aimed to standardise and validate ACE-III across seven Indian languages, and to assess the diagnostic accuracy of the test to detect dementia and mild cognitive impairment," Alladi added in a paper published in the Archives of Clinical Neuropsychology.
The researchers said a major proportion - 58 per cent - of people with dementia reside in low- and middle-income countries, and by 2050 that will increase to 68 per cent.
Therefore, standardising diagnostic tools for dementia is important to accurately determine prevalence rates and to establish risk and protective factors for dementia.
A total of 1203 participants from Hyderabad, Delhi, Trivandrum, Bengaluru and Puducherry were examined by an experienced neurologist.
The study included controls and participants who were diagnosed with dementia or mild cognitive impairment, but those with moderate or severe dementia were excluded.
In accordance with the original version of ACE-III, the Indian versions look at five different cognitive functions - attention, memory, fluency, language and visuospatial functions.
Each of the five domains of the test were evaluated for cultural relevance, translatability, comparable difficulty and adaptability.
For example, in the memory section, participants were asked about Indian politicians and movie actors.
"Accounting for cultural differences and linguistic characteristics of different populations is crucial for the development of a common instrument to diagnose dementia," noted Eneida Mioshi, professor of dementia care research at UEA's School of Health Sciences.
"The development of a common diagnostic tool will facilitate harmonisation of dementia research across diverse populations, and catalyse the development of preventative and treatment strategies for larger cohorts of dementia from diverse demographic and geographic backgrounds".
"This adapted version of ACE-III can be used to uniformly diagnose cognitive impairment in people speaking different languages from both rural and urban populations located across India." said Alladi.
Not only the ACE-III is a quick and inexpensive method of screening for dementia, it will also allow for harmonisation in future cross-national research studies, propelling Indian dementia research forward, the authors noted.